Provider Demographics
NPI:1467043166
Name:INTENSIVE BEHAVIOR CORP
Entity Type:Organization
Organization Name:INTENSIVE BEHAVIOR CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-266-9667
Mailing Address - Street 1:5700 LAKE WORTH RD STE 310-8
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4727
Mailing Address - Country:US
Mailing Address - Phone:786-266-9667
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE WORTH RD STE 310-8
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4727
Practice Address - Country:US
Practice Address - Phone:786-266-9667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty